Oeltmann and colleagues1(p189) report that “substance abuse is the most commonly reported behavioral risk factor among patients with TB [tuberculosis] in the United States.” The authors say that they controlled for other risk factors but did not look at one important behavioral risk factor: smoking. Previous studies have shown an association between smoking and tuberculosis in other countries.2,3 It is well known that persons with substance use disorders have higher smoking rates than the general population.4 I wonder whether the authors had access to data on smoking rates; if so, it would be helpful to see if this would influence their findings.
Rastegar DA. Tuberculosis and Substance Abuse. Arch Intern Med. 2009;169(13):1241-1247. doi:10.1001/archinternmed.2009.183